[Influence of the number of dissected lymph nodes on local recurrence of rectal carcinomas. A staging effect].
In 386 patients with rectal carcinoma of UICC stage I-III operated on between 1 January 1985 and 31 December 1995 we investigated the influence of the number of dissected lymph nodes on tumor stage and local recurrence retrospectively. We found a significant correlation between the number of lymph nodes dissected and the number of detected lymph node metastases. Following this result we found an increase in UICC stage III (P = 0.013) and pTx pN2 tumors (P = 0.000) in correlation with the number of dissected lymph nodes. Significantly lower rates of local recurrence were found only in UICC stage I and UICC stage II. Overall and in a multivariate analysis the number of dissected lymph nodes had no influence on local recurrence. It was shown that lower local recurrence rates in UICC stage I and II did not depend on therapeutic benefit but on stage migration because of more exact tumor staging. The influence of other surgical factors, especially total mesorectal excision, remains to be discussed.
Mörschel
M
M
Klinik für Allgemein- und Abdominalchirurgie, Universitätskliniken Mainz.
Heintz
A
A
Dutkowski
P
P
Böttger
T
T
Junginger
T
T
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*
Der Einfluss der Zahl der dissezierten Lymphknoten auf die Lokalrezidivrate rectaler Carcinome. Ein Stagingeffekt.